Am I now a type 3 Diabetic?

[Sonnyb2]

So your endo

 

[Wraakian]

@Wraakian - hi, I'm insulin deficient. I'm type 2 and was diagnosed in 1998. I've had the diagnostic tests done 3 times over the years. The last lot they did was beginning of 2010 where the c-peptide test result was in the red meaning I no longer produce the insulin I need. I'm on full time insulin therapy. I haven't changed diabetic type. My understanding is that insulin resistance can wear out your pancreas where it gets beta cell damage and stops producing the insulin you need. I still produce a little bit of insulin apparently but was told I need insulin therapy to treat my diabetes. I'm guessing you're in the same boat being that you've been type 2 for 30 years. Have your docs done the GAD and c-peptide test for you recently?

Thanks for the info ... I'm going to go back to the diabetic clinic at my local hospital in the New Year so will ask for the tests you mentioned but I think you're right and the time has come to introduce insulin into my regime as not many people go over 30 years without needing to do so. Thanks again ... Much appreciated ... Kind regards ... Jim

 

[Jaylee]

Hi Jaylee and a happy New Year to you too!
Thanks for you reply. Yes, I do take my levels b4 and after breakfast and they do not rise much as I only have a few raisins ... Maybe 6 - 9 max just to flavour the flax meal. It's the carbs that I can't tolerate so many if not all proprietary breakfast cereals including steel cut porridge oats are a no go for me as is bread ... except for hi-lo multi grain bread which I do get fed up of having instead of my wife's preferences Warburton's wholemeal which again puts my blook glucose sky high. I will try out no raisins to see if having them in the morning effects my bloods later in the day (over the usual 2 hours). Thanks again Jaylee ... Every input helps! Kind regards ... Jim

No problems, Jim.
All I know is they worked great as a hypo treatment.

I can also empathise that losing sight of the "wood for the trees" can happen when faced with a conundrum like blood going wild.

This diabetic mularkey can get like "pop up mole" whatever type we happen to be..!

Just keep us updated..
Wishing you all the best!

 

[DavidGrahamJones]

I need to convince them that I should go on to insulin but the nurse was totally against putting me on insulin at our last meeting?

Just to remind us how Victoza works:

Liraglutide functions over a 24-hour period to lower both fasting and post-prandial blood glucose levels, and help people with diabetes to manage their blood sugar.

Liraglutide works by stimulating the secretion of insulin as well as suppressing the secretion of glucagon in a glucose-dependent manner.

The drug also delays gastric (stomach) emptying, slowing down the absorption of glucose by the gut and reducing appetite.

With that in mind, I can only think that you need to know how your pancreas is doing. See if you can get a c-peptide test to tell you once and for all.

I'm no expert but have read that many years of taking drugs to make the pancreas work harder has an effect on the pancreas.

the diabetic nurse told me I should add more carbs to my diet which I have done and these latest figures are the result of that change too.

No surprise then? Although if you want more carbs, that is your prerogative. I hope they can get a drug regimen to suit your carb intake very soon. My type II father has been insulin dependent for several years now, his BG has also been poorly controlled. In his case he wasn't shown how to count carbs or anything, seemed to be finger in the air, guess and see how it goes, increasing the dose bit by bit. He has realised that keeping carbs down is better for him. The daily morning bowl of oats (he was told it was healthy) was the first to go.

All the best.

 

[ickihun]

Thanks ichihun, that is helpful info, having recently had a hip replacement I too have been unable to do my usual exercise programme which as you say doesn't help. If I can stay low carb without big rises in my blood glucose control that would be okay and I wouldn't need insulin but I have been a low carber for 2 years now and a bit fed up with it plus my blood levels seemed to rise even on a strict low carb diet so I may be at the stage of having to switch to insulin as a last resort though looking at what you've just told me it would still mean staying on low carbs forever. Thanks again ... Jim

It could be too much protein? If I eat too much protein it gets turned to fat but glucose first. More common than you think.
Are you a person who only likes a few individual items of food. None fussy foods, say?
I remember I got totally bored when I did lchf and was a bit relieved when I found out the cheese and nuts was stopping weight loss. I changed to low carb and low/medium fat and started losing weight. Even on insulin. I watched my protein levels and lost for 10months.
I had tried everything til then to lose even before 2 bulging discs, sciatica and numb leg with weakness.

A lot of the answers are in the diet for type2s unfortunately.

I find a few threads on here helpful for ideas on what to eat when I'm sick of eggs and chicken.
I hope you can download a decent low carb cookbook or similar to renew your appetite.

 

[Wraakian]

Just to remind us how Victoza works:

Liraglutide functions over a 24-hour period to lower both fasting and post-prandial blood glucose levels, and help people with diabetes to manage their blood sugar.

Liraglutide works by stimulating the secretion of insulin as well as suppressing the secretion of glucagon in a glucose-dependent manner.

The drug also delays gastric (stomach) emptying, slowing down the absorption of glucose by the gut and reducing appetite.

With that in mind, I can only think that you need to know how your pancreas is doing. See if you can get a c-peptide test to tell you once and for all.

I'm no expert but have read that many years of taking drugs to make the pancreas work harder has an effect on the pancreas.



No surprise then? Although if you want more carbs, that is your prerogative. I hope they can get a drug regimen to suit your carb intake very soon. My type II father has been insulin dependent for several years now, his BG has also been poorly controlled. In his case he wasn't shown how to count carbs or anything, seemed to be finger in the air, guess and see how it goes, increasing the dose bit by bit. He has realised that keeping carbs down is better for him. The daily morning bowl of oats (he was told it was healthy) was the first to go.

All the best.

Many thanks David, I asked the diabetic nurse about having a c-peptide test but she told me it wasn't readily available? I will ask again when I see her next time.

 

[ickihun]

Many thanks David, I asked the diabetic nurse about having a c-peptide test but she told me it wasn't readily available? I will ask again when I see her next time.

You may have to get your own done as majority of type2s produce too much insulin not none or low. If you weren't producing any insulin you would know by now. You would be losing weight drastically and bgs would be in 30s. Hba1c would be horrendously high constantly until insulin therapy was started. Insulin would be your only need.
I guess your team would have tested by now if they had those concerns. However I'm glad you asked so their response can be taken on board.

 

[DavidGrahamJones]

I asked the diabetic nurse about having a c-peptide test but she told me it wasn't readily available?

That's a very sad reflection of the NHS and a pathetic excuse. I know the NHS is struggling but there do seem to be times when a £90 (commercial price) blood test would answer a few questions rather than making assumptions. These people do several tests: https://www.medichecks.com/diabetes, and I notice they do an insulin test for £39 although I also note that they don't call it a c-peptide test, just the level of insulin in the blood. They do an insulin resistance test for £49.

I have used Geneva Labs as I have been fortunate in being able to fund my own blood tests, but I wish NHS personnel would just tell the truth, there's not enough money in the pot and they're saving money wherever they think fit. In fact I've just had to pay for a small surgical procedure which the consultant said was essential. Both Medichecks and Geneva have several test centres for drawing blood and they are not the only labs. Those tests have helped me take certain decisions rather than allowing the GP to throw more medication at me.

 

[Wraakian]

You may have to get your own done as majority of type2s produce too much insulin not none or low. If you weren't producing any insulin you would know by now. You would be losing weight drastically and bgs would be in 30s. Hba1c would be horrendously high constantly until insulin therapy was started. Insulin would be your only need.
I guess your team would have tested by now if they had those concerns. However I'm glad you asked so their response can be taken on board.

Thanks Ichihun, I would be scared if my bgs levels were 30 as I was worried when mine came back at 18 mmol/l. I managed to get my bgs down to 7.4 over the last 2 days but my low carb flax meal and chia seed with 4 walnuts (and without raisins) put me up after 2 hrs to 9.6 and then we went for a long walk at a National Trust park and had one of their beef pasties ... 2 hrs later I had gone up further to 12 7. Thought the long walk would have compensated for the extra carbs but alas it was not to be! Thanks again ... Jim

 

[Mep]

Many thanks David, I asked the diabetic nurse about having a c-peptide test but she told me it wasn't readily available? I will ask again when I see her next time.

I was getting readings regularly over 10mmol when I insisted on getting diagnostic testing re-done beginning of 2010. Here only the endocrinologists can request these tests apparently. I'm not sure if it's the same there in UK? Thankfully I've had an endo since diagnosis back in 1998. I stopped seeing them for a while and got a new one in 2005 and I've been seeing him ever since... he wants to see me every 6 months.

I should add that even though I wasn't getting extremely high sugar readings, my c-peptide test result was in the red. So you don't have to be getting extremely high readings to not be producing the insulin you need. It's really important to find out though. I was advised oral meds do not work if you do not produce sufficient insulin. Also I was advised that when your sugar reading is 10+ it means you have sugar in urine which is damaging to your kidneys, etc. So not worth the risk to not find out. I've had better control on insulin that's for sure.

 

[ickihun]

I was getting readings regularly over 10mmol when I insisted on getting diagnostic testing re-done beginning of 2010. Here only the endocrinologists can request these tests apparently. I'm not sure if it's the same there in UK? Thankfully I've had an endo since diagnosis back in 1998. I stopped seeing them for a while and got a new one in 2005 and I've been seeing him ever since... he wants to see me every 6 months.

I should add that even though I wasn't getting extremely high sugar readings, my c-peptide test result was in the red. So you don't have to be getting extremely high readings to not be producing the insulin you need. It's really important to find out though. I was advised oral meds do not work if you do not produce sufficient insulin. Also I was advised that when your sugar reading is 10+ it means you have sugar in urine which is damaging to your kidneys, etc. So not worth the risk to not find out. I've had better control on insulin that's for sure.

Were you only placed on insulin after a red c-peptide result @Mep?
Any insulin aiding meds before insulin?

Wow if not I wonder why your hba1c was so low for someone not producing insulin?

 

[ickihun]

Thanks Ichihun, I would be scared if my bgs levels were 30 as I was worried when mine came back at 18 mmol/l. I managed to get my bgs down to 7.4 over the last 2 days but my low carb flax meal and chia seed with 4 walnuts (and without raisins) put me up after 2 hrs to 9.6 and then we went for a long walk at a National Trust park and had one of their beef pasties ... 2 hrs later I had gone up further to 12 7. Thought the long walk would have compensated for the extra carbs but alas it was not to be! Thanks again ... Jim

Try and give up pastries and raisins or any fruit (dried or blended into smoothies) . Keeping fruit eating in your diet can help with fatty liver alongside other carbs and heavy meds.

 

[Wraakian]

I was getting readings regularly over 10mmol when I insisted on getting diagnostic testing re-done beginning of 2010. Here only the endocrinologists can request these tests apparently. I'm not sure if it's the same there in UK? Thankfully I've had an endo since diagnosis back in 1998. I stopped seeing them for a while and got a new one in 2005 and I've been seeing him ever since... he wants to see me every 6 months.

I should add that even though I wasn't getting extremely high sugar readings, my c-peptide test result was in the red. So you don't have to be getting extremely high readings to not be producing the insulin you need. It's really important to find out though. I was advised oral meds do not work if you do not produce sufficient insulin. Also I was advised that when your sugar reading is 10+ it means you have sugar in urine which is damaging to your kidneys, etc. So not worth the risk to not find out. I've had better control on insulin that's for sure.

Thanks again David, that is very useful information and I will definitely insist on a c-peptide test ... I now have an appointment with the diabetic specialist 25th January so should hopefully receive better help then. Sounds like you have had to motivate the system in order to get better results and I guess I will have to do the same here.
Thanks once again David
Kind regards
Jim

 

[Wraakian]

With regards to the pasties and raisins, I do not usually have the pasties as I know they put up the levels but when I go out there isn't much choice at many restaurants or cafes. At the National Trust place we visited they only had potato soup or pies and pasties so not much choice at all and we were hungry. It would be far better if every café and restaurant had a low carb choice as with my New Year's eve party meal where I had Sea Bass without potatoes but with extra veg instead and in place of all the high sugar desserts they offered me a very health diabetic friendly berry fruit salad all of which was excellent. Why can't we educate food outlets to offer low carb alternatives? With regards to the raisins I have stopped putting these (very few (7)) in my low carb breakfast but they have never raised my blood sugars when I have checked after 2 hours and they help with my 7 a day fruit and veg.

 

[Mep]

Were you only placed on insulin after a red c-peptide result @Mep?
Any insulin aiding meds before insulin?

Wow if not I wonder why your hba1c was so low for someone not producing insulin?

Yes, I was on a mix of oral meds which included metformin with some other drug for 5 years. The last couple of years of that period I was getting hbA1c of 9.2% on average which docs weren't happy with. I was frequently getting over 10 on my meter though and I was trying very hard with diet and exercise. At that point I was exercising a minimum of 2 hours every day... 1.5 hour cardio and 1/2 weight training. No matter what I did I couldn't get my levels below 7 a lot of the time. I insisted on getting the GAD test and c-peptide test beginning of 2010 as I was sick of all the effort and no result. I'm glad I did that because otherwise I would've been carrying on flogging a dead horse so to speak. If you don't produce sufficient insulin, oral meds won't work my endo said.

 

[ickihun]

My endo said I'll only need basal insulin after bariatric op and metformin so I hope he's right. Mind u still just under 19st after losing 3.5st in 2017.
Looking to emulate January '17 again as had a carby xmas.
Still taking huge amounts of toujeo300 insulin but 20units per meal of novarapid.

 

[Mep]

My endo said I'll only need basal insulin after bariatric op and metformin so I hope he's right. Mind u still just under 19st after losing 3.5st in 2017.
Looking to emulate January '17 again as had a carby xmas.
Still taking huge amounts of toujeo300 insulin but 20units per meal of novarapid.

Yeh if you still are producing sufficient insulin you probably could come off the bolus when you lose the weight too. I was told I can't come off insulin but that's because I no longer produce what I need. I'm currently needing to lose weight too and probably the only thing that may change is dosage maybe. I'll see how I go.

 

[Wraakian]

looking over what's happening to you, if it was I, before dealing with the weight gain propensities of insulin or all the calculations that insulin implies, I think I would scale down, go the max of ER Metformin which is maybe 2400, spread out over the 24 hour period, top off the meal with a couple three fenugreek capsules to cover expected spikes, definitely rid myself of the glicazide, only take exenatide, not lovaza (more side effects) if and only if I did not have any kind of thyroid disease or thyroid nodules, cover the Metformin use with a daily high dose co-enzyme Q10, cut out all cereals and dried fruit, have an occasional half a small apple maybe if blood sugars warrant it, have more soup, and just let a body rest from all those drugs you are subjecting it to. I feel you are already on too many conflicting drugs with too many stresses to those drugs in the form of carbs.

And, at your age, are you also popping a few pills for the co-morbidities? A heart drug? A synthetic statin? Anything else? A complex conundrum[/QUOTE

Thanks Contralto, yes, the GP put me on stating some years ago. Interesting that you mention Q10 as being helpful in balancing blood sugars after meals ... will check it out further. Wouldn't coming off my gliclazide considerably raise my glucose levels ... I have always been told that they were the one meds that helped the most to lower my levels? I've never heard of exenatide but will look into that too. Many thanks for your input ... Much appreciated
Kind regards
Jim